How much rates vary
Facilitymedian $214 · 10th to 90th $132 to $380Professionalmedian $316 · 10th to 90th $200 to $589
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $131.83 Median $213.80 Typical High $213.80 | Facility | None | $131.83 | $213.80 | $213.80 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $100.00 Median $100.00 Typical High $158.49 | Facility | 54 · Surgery only | $100.00 | $100.00 | $158.49 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $199.53 Typical High $245.47 | Professional | None | $131.83 | $199.53 | $245.47 |
BCBS North Dakota Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $416.87 | Facility | None | $338.84 | $338.84 | $416.87 |
BCBS North Dakota Setting Professional Modifier None Typical Low $257.04 Median $371.54 Typical High $588.84 | Professional | None | $257.04 | $371.54 | $588.84 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $309.03 Median $446.68 Typical High $707.95 | Professional | 22 · Increased work | $309.03 | $446.68 | $707.95 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $263.03 Typical High $416.87 | Professional | 54 · Surgery only | $181.97 | $263.03 | $416.87 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $281.84 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $194.98 | $281.84 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $436.52 | Facility | None | $380.19 | $380.19 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $331.13 Typical High $691.83 | Professional | None | $190.55 | $331.13 | $691.83 |
Medica Setting Facility Modifier None Typical Low $131.83 Median $213.80 Typical High $371.54 | Facility | None | $131.83 | $213.80 | $371.54 |
Medica Setting Professional Modifier None Typical Low $218.78 Median $389.05 Typical High $457.09 | Professional | None | $218.78 | $389.05 | $457.09 |
United Setting Facility Modifier None Typical Low $125.89 Median $251.19 Typical High $269.15 | Facility | None | $125.89 | $251.19 | $269.15 |
United Setting Professional Modifier None Typical Low $138.04 Median $251.19 Typical High $407.38 | Professional | None | $138.04 | $251.19 | $407.38 |
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $66.07 Median $66.07 Typical High $107.15 | Facility | 52 · Reduced service | $66.07 | $66.07 | $107.15 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $26.30 Median $26.30 Typical High $42.66 | Facility | 53 · Discontinued | $26.30 | $26.30 | $42.66 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $19.95 Median $19.95 Typical High $31.62 | Facility | 55 · Aftercare only | $19.95 | $19.95 | $31.62 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $13.18 Median $13.18 Typical High $21.38 | Facility | 56 · Pre-op care only | $13.18 | $13.18 | $21.38 |
Where North Dakota sits
The same service costs 8.8 times more in New York than in Alabama. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
NY $2,761AL $314
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.